Individual provider Active NPI

Pegah Gheitani, RPA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1598079444
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014068 Issued in NY
Practice address
161 Fort Washington Ave FL 8
New York, NY 10032-3729
Phone
(212) 305-9468
Fax
(212) 304-4585
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 014068 NY Primary

Addresses

Primary practice location

161 Fort Washington Ave FL 8
New York, NY 10032-3729

Mailing address

161 Fort Washington Ave FL 8
New York, NY 10032-3729
Phone (212) 305-9468

Other practice location 1

161 Fort Washington Ave Fl 8
New York, NY 10032-3729
Phone (212) 342-1734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150515000244 NY Practitioner - Physician Assistant 3678893633 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayer J Saad MD PCGroup PAC ID 2769629914, 44 clinicians

Practice addresses (Care Compare)

158 Hempstead Ave
Lynbrook, NY 11563-1605
Phone (516) 881-9560

372 Post Ave
Suite 106
Westbury, NY 11590-2201
Phone (516) 333-1444

514 Ocean Ave
Massapequa, NY 11758-4605
Phone (516) 799-4500

8212 151St Ave
Howard Beach, NY 11414-1793
Phone (718) 843-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Jun 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Jun 1, 2018 Accepting new patients
Nsuh Plainview Physicians Ufp Corporation PastSince Jan 12, 2026 Accepting new patients
Bethpage Medical, PLLC PastSince Apr 8, 2022 Accepting new patients

Locations

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

161 Fort Washington Ave
Fl 8
New York, NY 10032
Phone (212) 342-1155

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1598079444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-305-9468",
            "fax_number": "212-304-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-305-9468",
            "fax_number": "212-304-4585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Fort Washington Ave Fl 8",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323729",
            "country_code": "US",
            "telephone_number": "212-342-1734",
            "fax_number": "212-342-5754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHEITANI",
        "first_name": "PEGAH",
        "name_prefix": "Miss",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.